Download Anxiety and Depression

Anxiety and Depression
General Facts
Anxiety and Depression are both very common, yet highly treatable, medical illnesses that can affect anyone. Anxiety disorders
are the most common mood disorder in the U.S. More than 1 in 20 Americans get depressed every year. One half of those
diagnosed with depression are also diagnosed with an anxiety disorder. These are medical disorders (just like diabetes and high
blood pressure) that affect your thoughts, feelings, physical health and behaviors.
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Depression Symptoms Include:
Anxiety Symptoms Include:
Feeling sad or unhappy
Loss of interest in things you usually enjoy
Feeling slowed down or restless
Having trouble sleeping or sleeping too much
Loss of energy or feeling tired all the time
Having an increase or decrease in appetite or
weight
Having problems concentrating, thinking,
remembering or making decisions
Feeling worthless or guilty
Having thoughts of death or suicide
It appears to be a variety of factors including:
 Restlessness
 Easily fatigued
 Difficulty concentrating
 Irritability
 Muscle tension
 Sleep problems
 Chest pain
 Palpitations
 Shortness of breath
 Numbness/tingling
Causes/Risk Factors:
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It appears to be a variety of factors including:
Imbalance of neurochemicals in the brain
Family history of depression/anxiety
Stressful life events
History of alcohol/Substance abuse
Early childhood trauma
Personal past history of depression/anxiety
Certain medications
Personality
Treatment
The good news is that treatment works. Treatment can involve medications, counseling or both. There are also some lifestyle
measures that may help as well, see the following recommendations.
Lifestyle Measures
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Take good care of yourself - Eat well and try to get at least 7 hours or sleep.
Stay physically active – Make sure you make time to address your basic physical needs, for example, walking for a
certain amount of time each day.
Make time for pleasurable activities – Even though you may not feel as motivated, or get the same amount of
pleasure as you used to, commit to scheduling some fun activity each day – for example, doing a hobby, listening to
music or watching a video.
Spend time with people who can support you – It’s easy to avoid contact with people when you’re depressed, but
you need the support of friends and loved ones. Explain to them how you feel, if you can. If you can’t talk about it,
that’s OK – just ask them to be with you, maybe accompanying you on one of your activities.
Practice relaxing – For many people, the changes that come with depression – no longer keeping up with our usual
activities and responsibilities, feeling increasingly sad and hopeless – leads to anxiety. Since physical relaxation can
lead to mental relaxation, practicing relaxation is another way to help yourself. Try deep breathing, or a warm bath, or
just finding a quiet, comfortable, peaceful place and saying comforting things to yourself (like “it’s OK”).
Approved by the UHS Patient Education Committee
Revised 04/25/2017
Page 1 of 3
Anxiety and Depression
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Simple goals and small steps – It’s easy to feel overwhelmed when you’re depressed. Some problems and
decisions can be delayed, but others cannot. It can be hard to deal with them when you’re feeling sad, have little
energy, and not thinking clearly. Try breaking things down into small steps. Give yourself credit for each step you
accomplish.
Avoid self-medicating – Using alcohol or drugs not prescribed for you.
Medications
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Selective serotonin reuptake inhibitors (SSRIs). Many doctors start depression treatment by prescribing an SSRI.
These medications are safer and generally cause fewer bothersome side effects than other types of antidepressants.
SSRIs include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram
(Lexapro) and others.
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The most common side effects include jitteriness, restlessness, agitation, headache, diarrhea and nausea
and insomnia. Some side effects may go away as your body adjusts to the medication.
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Sexual side effects (loss of sexual desire, diminished arousal, and difficulty having an orgasm) may also
occur with prolonged use of the SSRIs; however, adding another drug (such as bupropion [Wellbutrin®] or
buspirone [BuSpar®] can sometimes relieve these sexual side effects.
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Serotonin syndrome. Rarely, an SSRI can cause dangerously high levels of serotonin. This is known as
serotonin syndrome. It most often occurs when two medications that raise serotonin are combined. These
include other antidepressants, medications for certain health conditions and the herbal supplement St. John’s
wort. Signs and symptoms of serotonin syndrome include confusion, rapid or irregular heart rate, dilated
pupils, fever, and unconsciousness. Seek immediate medical attention if you have any of these signs or
symptoms.
Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications include duloxetine (Cymbalta),
venlafaxine (Effexor XR) and desvenlafaxine (Pristiq).
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Common side effects include nausea, dizziness, insomnia, sedation, and constipation. Rarely, these drugs
also cause increased sweating. People taking venlafaxine should have regular blood pressure checks, since
it may cause blood pressure to rise.
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Norepinephrine and dopamine reuptake inhibitors (NDRIs). Bupropion (Wellbutrin) is in this category. Bupropion
has few side effects, but it has been associated with seizures in people with eating disorders; it is not recommended for
people who have bulimia or anorexia. The drug carries a small risk of seizures in other people as well. Other side
effects of bupropion may include mild anxiety or insomnia and decreased appetite with weight loss. Unlike other
antidepressants, bupropion does not have sexual side effects. It is sometimes used at low doses to help counter the
sexual side effects of other antidepressants.
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Other medication strategies. Your doctor may suggest other medications to treat your depression. In some cases,
your doctor may recommend combining two or more antidepressants or other medications for better effect.
Important Medication Facts
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The Food and Drug Administration (FDA) requires that all antidepressants and some anti-anxiety medications carry a
warning that some children, adolescents and young adults may be at increased risk of suicide when taking them.
Anyone taking these medications should be watched closely for worsening depression or unusual behavior – especially
in the first few weeks after starting the medication. Keep in mind, these medications are more likely to reduce suicide
risk in the long run by improving mood.
Take medications as prescribed.
Approved by the UHS Patient Education Committee
Revised 04/25/2017
Page 2 of 3
Anxiety and Depression
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Antidepressants are not addictive.
Benefits from certain medication appear slowly. Full effects are not usually seen until 4-6 weeks of treatment are
complete.
Continue medications even after you feel better.
Most medications are taken for at least 6-12 months.
Mild side effects are common and usually improve with time.
If you’re thinking about stopping the medication, call your clinician first. Some medications may cause a
discontinuation syndrome if not tapered slowly. Symptoms may include dizziness, nausea, headache, fatigue, muscle
aches, chills, anxiety and irritability.
The goal of treatment is complete remission. Sometimes it takes a few different medications to find the best one.
PSU Crisis: 24/7 877-229-6400
Crisis Text: Text LIONS to 741741
CAN HELP: 1-800-643-5432 is the community’s 24-hour crisis service.
In an emergency go to Mount Nittany Medical Center or call 911 for an ambulance.
Test Results and Advice Nurse
Send secure message to advice nurse via the UHS website or call 814- 863-4463.
Appointments
Appointments can be made online via the UHS website, by phone 814-863-0774, or in person. If you are unable to keep your
appointment, please call or go online to cancel. Otherwise you will be charged for the visit.
This content is reviewed periodically and is subject to change as new health information becomes available. This information is intended to
inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Approved by the UHS Patient Education Committee
Revised 04/25/2017
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